THF 2026 Summer Camp - Pickering
Camper's Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
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Day
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2026
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Address
*
Street Address
Street Address Line 2
City
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Postal / Zip Code
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Family Information
Parent/Guardian's Name
*
First Name
Last Name
Contact Phone Number
*
Format: (000) 000-0000.
E-mail Address
*
example@example.com
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Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Format: (000) 000-0000.
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Please provide any medical conditions or other information if applicable
Select Camp shirt size
*
Youth Small
Youth Medium
Youth Large
Youth X-large
Adult Small
Adult Medium
Adult Large
Adult X-Large
I acknowledge, appreciate, and agree that: 1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Releasees, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. MEDIA RELEASE: I agree and give consent for the King Nation Basketball organization and/or partners to record, film, photograph, audiotape or videotape my child's name, image, and performance and consent to use for advertising, promotional or commercial purposes of any kind at the sole discretion of King Nation Basketball including, but not limited to, the King Nation Basketball website and all social media platforms. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
*
I Agree
EPI-PEN AUTHORIZATION and WAIVER OF LIABILITY I have informed King Nation Basketball of all my child's allergies, if any. If you have indicated an allergy that requires your child to have a Epi-Pen, medication must be left with the Camp Supervisor. It must be in the original container, and be clearly labeled with your child's full name, prescriber's name, directions for administration and expiration date. I hereby authorize King Nation Basketball Staff and agents on my behalf, to administer or attempt to administer to my child, or allow my child to self administer the lawfully prescribed EpiPen. I acknowledge that it may be necessary for the epi-pen medication to be administered to my child by an individual who is not a nurse or medical professional, and I specifically consent to such practice. I hereby waive any claim for myself, my heirs, executors, assigns, or personal representative that I might have against King Nation Basketball, its employees, officials, or agents from and against any and all claims, damages or causes of action arising out of or in any way connected to the self-administration, administration, failure to administer, or attempt to administer epi-pen medication to my child. I further agree to protect, indemnify, defend and hold harmless King Nation Basketball, its employees, officials or agents arising out of or in any way connected to the self administration, administration, failure to administer or attempt to administer medication to my child. I authorize and recommend self-medication by my child for the epi-pen medication. In the event my child is unable to self-administer or if I have recommended that my child not self- administer, Staff have my permission to administer the epi pen for my child in the event of an allergic reaction.
*
I Agree
Select Week(s) of Camp
*
Week 1: July 6 - 10
Week 2: July 13 - 17
Week 3: July 20 - 24
Week 4: July 27 - 31
Week 5: August 4 - 7 (Short Week)
Week 6: August 10 - 14
Week 7: August 17 - 21
Please select an option and update Quantity to reflect number of weeks selected
*
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Half Day Camp | Monday - Friday | 9:00 AM - 12:00 PM
$
250.00
CAD
Quantity
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Half Day Camp | Monday - Friday | 1:00 PM - 4:00 PM
$
250.00
CAD
Quantity
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Full Day Camp | Monday - Friday | 9:00 AM - 4:00 PM
$
350.00
CAD
Quantity
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9
10
Credit Card Details
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Last Name
Credit Card Number
Security Code
Card Expiration
Signature
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Date
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